Incidence of cancer and cancer related mortality in opiate dependent patients treated with methadone, buprenorphine or implant naltrexone as compared with non-opiate using controls

Erin Kelty, Timothy Dobbins, Gary Hulse

    Research output: Contribution to journalArticle

    Abstract

    Background: Cancer has been identified as a common cause of mortality in opiate dependent patients. Aim: To examine
    and compare the incidence of cancer and cancer mortality in opiate dependent patients treated with methadone, buprenorphine
    or implant naltrexone to a cohort of controls taken from the general population. Methods: The study was a retrospective
    longitudinal follow up using routinely collected cancer and mortality data. Participants included opiate dependent
    patients treated for the first time with methadone (n=2,227), buprenorphine (n=1,954) or implant naltrexone (n=958)
    between 2001 and 2010 in Western Australia (WA) and a sex and age matched cohort of controls selected from the WA
    electoral roll. Incidence of cancer and cancer related mortality in the four groups were analyzed using Cox proportional
    hazard regression. Results: Rates of cancer in opiate patients treated with methadone (HR:0.81, CI:0.49-1.34), buprenorphine
    (HR:0.74, CI:0.41-1.33) and naltrexone (HR:0.65, CI:0.28–1.50) participants were not significantly different to the
    control cohort. Rates of respiratory cancer were elevated in patients initially treated with methadone (HR:7.53, CI:1.46–
    38.93) and naltrexone (HR:7.65, CI:1.07–54.48). Mortality rates in patients diagnosed with cancer were significantly
    elevated in patients treated in methadone (HR:3.19, CI:1.07–9.53), while both buprenorphine (HR:3.07, CI:0.78–12.15)
    and naltrexone (HR:3.73, CI:0.77–18.02) were not dissimilar to the controls. Conclusions: While rates of cancer were not
    significantly different to the control, poor survival may attribute to high rates of cancer related mortality.
    LanguageEnglish
    Pages65-72
    Number of pages8
    JournalHeroin Addiction and Related Clinical Problems
    Volume19
    Issue number3
    StatePublished - 1 Jun 2017

    Fingerprint

    Opiate Alkaloids
    Buprenorphine
    Naltrexone
    Methadone
    Mortality
    Incidence
    Neoplasms
    Western Australia
    Respiratory Rate

    Cite this

    @article{6cf037f0d2fc47148dedd307261edda1,
    title = "Incidence of cancer and cancer related mortality in opiate dependent patients treated with methadone, buprenorphine or implant naltrexone as compared with non-opiate using controls",
    abstract = "Background: Cancer has been identified as a common cause of mortality in opiate dependent patients. Aim: To examineand compare the incidence of cancer and cancer mortality in opiate dependent patients treated with methadone, buprenorphineor implant naltrexone to a cohort of controls taken from the general population. Methods: The study was a retrospectivelongitudinal follow up using routinely collected cancer and mortality data. Participants included opiate dependentpatients treated for the first time with methadone (n=2,227), buprenorphine (n=1,954) or implant naltrexone (n=958)between 2001 and 2010 in Western Australia (WA) and a sex and age matched cohort of controls selected from the WAelectoral roll. Incidence of cancer and cancer related mortality in the four groups were analyzed using Cox proportionalhazard regression. Results: Rates of cancer in opiate patients treated with methadone (HR:0.81, CI:0.49-1.34), buprenorphine(HR:0.74, CI:0.41-1.33) and naltrexone (HR:0.65, CI:0.28–1.50) participants were not significantly different to thecontrol cohort. Rates of respiratory cancer were elevated in patients initially treated with methadone (HR:7.53, CI:1.46–38.93) and naltrexone (HR:7.65, CI:1.07–54.48). Mortality rates in patients diagnosed with cancer were significantlyelevated in patients treated in methadone (HR:3.19, CI:1.07–9.53), while both buprenorphine (HR:3.07, CI:0.78–12.15)and naltrexone (HR:3.73, CI:0.77–18.02) were not dissimilar to the controls. Conclusions: While rates of cancer were notsignificantly different to the control, poor survival may attribute to high rates of cancer related mortality.",
    keywords = "Buprenorphine, Cancer, Methadone, Mortality, Naltrexone, Opiate dependence",
    author = "Erin Kelty and Timothy Dobbins and Gary Hulse",
    year = "2017",
    month = "6",
    day = "1",
    language = "English",
    volume = "19",
    pages = "65--72",
    journal = "Heroin Addiction and Related Clinical Problems",
    issn = "1592-1638",
    publisher = "Pacini Editore s.r.l.",
    number = "3",

    }

    TY - JOUR

    T1 - Incidence of cancer and cancer related mortality in opiate dependent patients treated with methadone, buprenorphine or implant naltrexone as compared with non-opiate using controls

    AU - Kelty,Erin

    AU - Dobbins,Timothy

    AU - Hulse,Gary

    PY - 2017/6/1

    Y1 - 2017/6/1

    N2 - Background: Cancer has been identified as a common cause of mortality in opiate dependent patients. Aim: To examineand compare the incidence of cancer and cancer mortality in opiate dependent patients treated with methadone, buprenorphineor implant naltrexone to a cohort of controls taken from the general population. Methods: The study was a retrospectivelongitudinal follow up using routinely collected cancer and mortality data. Participants included opiate dependentpatients treated for the first time with methadone (n=2,227), buprenorphine (n=1,954) or implant naltrexone (n=958)between 2001 and 2010 in Western Australia (WA) and a sex and age matched cohort of controls selected from the WAelectoral roll. Incidence of cancer and cancer related mortality in the four groups were analyzed using Cox proportionalhazard regression. Results: Rates of cancer in opiate patients treated with methadone (HR:0.81, CI:0.49-1.34), buprenorphine(HR:0.74, CI:0.41-1.33) and naltrexone (HR:0.65, CI:0.28–1.50) participants were not significantly different to thecontrol cohort. Rates of respiratory cancer were elevated in patients initially treated with methadone (HR:7.53, CI:1.46–38.93) and naltrexone (HR:7.65, CI:1.07–54.48). Mortality rates in patients diagnosed with cancer were significantlyelevated in patients treated in methadone (HR:3.19, CI:1.07–9.53), while both buprenorphine (HR:3.07, CI:0.78–12.15)and naltrexone (HR:3.73, CI:0.77–18.02) were not dissimilar to the controls. Conclusions: While rates of cancer were notsignificantly different to the control, poor survival may attribute to high rates of cancer related mortality.

    AB - Background: Cancer has been identified as a common cause of mortality in opiate dependent patients. Aim: To examineand compare the incidence of cancer and cancer mortality in opiate dependent patients treated with methadone, buprenorphineor implant naltrexone to a cohort of controls taken from the general population. Methods: The study was a retrospectivelongitudinal follow up using routinely collected cancer and mortality data. Participants included opiate dependentpatients treated for the first time with methadone (n=2,227), buprenorphine (n=1,954) or implant naltrexone (n=958)between 2001 and 2010 in Western Australia (WA) and a sex and age matched cohort of controls selected from the WAelectoral roll. Incidence of cancer and cancer related mortality in the four groups were analyzed using Cox proportionalhazard regression. Results: Rates of cancer in opiate patients treated with methadone (HR:0.81, CI:0.49-1.34), buprenorphine(HR:0.74, CI:0.41-1.33) and naltrexone (HR:0.65, CI:0.28–1.50) participants were not significantly different to thecontrol cohort. Rates of respiratory cancer were elevated in patients initially treated with methadone (HR:7.53, CI:1.46–38.93) and naltrexone (HR:7.65, CI:1.07–54.48). Mortality rates in patients diagnosed with cancer were significantlyelevated in patients treated in methadone (HR:3.19, CI:1.07–9.53), while both buprenorphine (HR:3.07, CI:0.78–12.15)and naltrexone (HR:3.73, CI:0.77–18.02) were not dissimilar to the controls. Conclusions: While rates of cancer were notsignificantly different to the control, poor survival may attribute to high rates of cancer related mortality.

    KW - Buprenorphine

    KW - Cancer

    KW - Methadone

    KW - Mortality

    KW - Naltrexone

    KW - Opiate dependence

    UR - http://www.scopus.com/inward/record.url?scp=85018284977&partnerID=8YFLogxK

    M3 - Article

    VL - 19

    SP - 65

    EP - 72

    JO - Heroin Addiction and Related Clinical Problems

    T2 - Heroin Addiction and Related Clinical Problems

    JF - Heroin Addiction and Related Clinical Problems

    SN - 1592-1638

    IS - 3

    ER -